You can now collect chronic meds from Post Offices, but pharmacists are worried

Business Insider SA
(Photo by Gallo Images/Sharon Seretlo)
(Photo by Gallo Images/Sharon Seretlo)
  • Patients can now collect their chronic medication from more than 300 Post Office branches across South Africa, excluding the Western Cape.
  • The Post Office says it has trained staff to handle medication, and that it uses "existing high-security storage".
  • But the Pharmaceutical Society of South Africa has raised concerns about the Post Office's ability to comply with the rules for keeping medicines safe and secure.
  • The South African Health Products Authority, responsible for upholding the Medicines and Related Substances Act, said questions of compliance should be directed to the South African Pharmacy Council.
  • The South African Pharmacy Council said it wasn't consulted and knew very little about how medicines were packaged, transported, stored, and distributed by the Post Office.
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The South African Post Office now allows patients to collect chronic medication from more than 300 branches. Pharmacists have raised serious concerns about how this medication is stored and handled.

South Africa's Post Office is trying to reinvent itself. The state-owned postal service is technically insolvent. It hasn't made a profit in more than a decade. Its C-suite titles have been gutted, signalling a severe skills shortage. It's been forced to close branches due to non-payment of rentals. Its mail-delivery performance remains well below target.

The Post Office's turnaround strategy includes a controversial legal bid to stop all other couriers from delivering packages weighing less than 1kg. The SAPO wants to modernise its IT systems and provide new online services. It also wants at least R1.6 billion from the government, the latest in a long line of taxpayer-funded cash injections to keep the SAPO afloat.

Amid the Post Office's dire operational and financial circumstances, it announced earlier in June that it would be handling and distributing chronic medication. This service, which allows patients who would ordinarily get their medication from government clinics to collect from the Post Office, is now offered at 342 branches across the country, except the Western Cape.

"The service is aimed at patients who live or work closer to one of these post offices than a government clinic," said the SAPO in announcing the partnership with the department of health.

These patients can arrange the alternate collection of medication with their local clinic. Instead of the medication being collected from the clinic, it can be collected from a SAPO branch when notified by an SMS delivered by the department of health. Patients have 14 days to collect the medication before it's returned to the department of health.

This arrangement was concluded between the SAPO and provincial departments of health, which would explain why branches in the Western Cape have been excluded.

"We certainly hope to offer the service there as well, and we are still engaging the Western Cape provincial government on this issue," Post Office spokesperson Johan Kruger told Business Insider South Africa.

The transport, handling, and storage of scheduled medicines are carefully regulated in South Africa, and questions arise on whether the SAPO can meet these stringent requirements.

"Medicines are not a normal commodity of trade, as the storage and distribution require very stringent control requirements, such as the maintenance of the cold chain to ensure product stability and safety," Ivan Kotzé, executive director of the Pharmaceutical Society of South Africa (PSSA), told Business Insider SA.

South Africa's Medicines and Related Substances Act sets clear rules around what can and can't be done with medicines. These legislative mandates, which, in part, deal with the keeping, storage, processing and packing of medicines, are upheld by the South African Health Products Authority (SAHPRA).

The health product regulator, when questioned by Business Insider SA, indicated that this was not its "area" and that the South African Pharmacy Council (SAPC) would be better placed to deal with issues of compliance.

But the SAPC wasn't consulted and only, upon being approached by Business Insider SA for comment, included the matter on the agenda for a board meeting on Wednesday. The exact arrangement between the SAPO and provincial departments of health, concerning measures in place to ensure the safety and security of medication scheduled for collection at branches, remains unclear.

“We are yet to establish the nature of the arrangement between the Department of Health and the South African Post Office and the details in relation to the handling, storage, and dispensing of the medicines,” Vincent Tlala, Registrar and CEO of the SAPC, told Business Insider SA.

“However, we wish to stress that medicines should be dispensed and stored by or under the direct supervision of a pharmacist or other registered healthcare professional holding the relevant permit, in line with Regulation 21 of the Regulations relating to the practice of pharmacy (GNR. 1158 of 2000).”

“We are unable to express ourselves concerning the Post Office’s ability to comply with legislative requirements in relation to the storage, handling and dispensing of medicines as we are not privy to the arrangement between themselves and the Department of Health.”

These concerns are shared by the PSSA, with Kotzé pointing to consultations with both SAHPRA, as the regulator responsible for the control and possession of medicines and scheduled substances, and the SAPC, as the regulator of the pharmacy profession responsible for control requirements, being important to understanding the Post Office's new collection service.

"It is my opinion that the Post Office services in South Africa can not ensure compliance with the Good Pharmacy Practice requirements, and if pharmacists are 'forced' to distribute medicines through the postal service, that this will present with a practice risk for the pharmacist professional involved," said Kotzé.

"A question that can arise is what will happen when there are labour strikes by Post Office staff, as critical medicines will under these circumstances not be available."

The Post Office told Business Insider SA that "existing staff received training" and that branches' "existing high-security storage is used" to store chronic medication.

"One important difference is that medication is returned to the department of health after 14 days of not being collected. Ordinary parcels are kept for 60 days before they are returned to sender," said Kruger. 

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